Is maternal smoking during pregnancy associated with an increased risk of congenital heart defects among offspring? A systematic review and meta-analysis of observational studies

<p><i>Objective</i>: To investigate the association between maternal smoking during pregnancy and risk of congenital heart defects (CHDs) among offspring.</p> <p><i>Methods</i>: PubMed, EMBASE, and Web of Science were searched for eligible studies. The outcomes of interest included risk of any CHD and nine subtypes. We summarized study characteristics and used a random-effects model in meta-analysis, and a two-stage dose–response model was utilized to assess the association between smoking consumption and risk. Statistical heterogeneity was assessed by a chi-squared test of the Cochrane Q statistic and I-squared value. Publication bias was assessed by funnel plots and Egger’s test, and trim and fill method was utilized when publication bias existed.</p> <p><i>Results</i>: Forty-three observational epidemiologic studies were included. The pooled risk ratio (RR) of any CHD was 1.11 (95% CI: 1.04, 1.18), but it exhibited substantial statistical heterogeneity (<i>p</i> < 0.001, <i>I</i>²=69.0%). In sensitivity analysis, we observed significant associations for atrial septal defect (ASD) and marginally significant associations for septal defects (SPD). The two-stage dose–response analysis showed evidence to support that higher levels of tobacco smoke was associated with an increased risk of septal defects, particularly for ASD and VSD (ventricular septal defect).</p> <p><i>Conclusion</i>: Our study presents evidence to support the cardiovascular teratogenic effect of maternal smoking during pregnancy, and their offspring may suffer from approximately a 10% relative increase in the risk of CHDs on average.</p

Boosting Reversibility of Conversion/Alloying Reactions for Sulfur-Rich Antimony-Based Sulfides with Extraordinary Potassium Storage Performance

As a new sort of energy storage device, potassium-ion batteries (PIBs) have broad application prospects in the post-lithium-ion battery era. Among the massive anode materials for PIBs, Sb-based sulfides have attracted much attention because of their high potassium storage capacity and abundant resources. However, the huge volume expansion, sluggish K+ storage kinetics, and low reaction reversibility hinder their applications. Here we composited commercial Sb2S5 with cobalt- and nitrogen-codoped carbon (CoNC) via a facile ball-milling strategy, making it an efficient anode material for PIBs. The synergistic effect between the catalysis of Co and buffering of the carbon matrix enhances the reversibility of the conversion/alloying reaction, alleviates the volume inflation, and improves the electrochemical kinetics, thus enabling the electrode to exhibit enhanced electrochemical performance. The prepared anode delivers a high reversible specific capacity (468.5 mAh g–1 at 500 mA g–1) and outstanding cycling stability (98% capacity retention after 150 cycles). In situ characterization clarified its potassium storage mechanism, and theoretical calculations revealed the reason for the improved electrochemical performance

Integrated Anodes from Heteroatoms (N, S, and F) Co-Doping Antimony/Carbon Composite for Efficient Alkaline Ion (Li⁺/K⁺) Storage

Sb-based materials are widely used in alkali metal-ion batteries due to large specific capacity, low cost, and a suitable operating voltage platform. However, they suffer from tardy dynamic performance and structural instability, along with a vague storage mechanism for alkali metal ion (Li+/K+) confining their further popularization. Herein, a scalable strategy is proposed to make Sb nanoparticles encapsulated in the N, S, and F co-doping carbon skeleton (Sb@NSF-C) with a three-dimensional ordered hierarchical porous structure. The Sb@NSF-C composite shows remarkable electrochemical performances in lithium-ion batteries (LIBs) and potassium-ion batteries (PIBs) due to improved Li+/K+ diffusion kinetics, rapid ion transport path, and stable structure. The Li+/K+ storage mechanism is detailedly investigated for the Sb@NSF-C composite. This work may provide a feasible method to design electrode materials for LIBs and PIBs with excellent performances

0.7% Roll-off for Solution-Processed Blue Phosphorescent OLEDs with a Novel Electron Transport Material

A novel cross-linkable electron transport material, 1,3,5-tris­(5-(4-vinylphenyl)­pyridin-3-yl)­benzene (TV-TmPY), for solution-processing as well as a small molecule, 1,3,5-tris­(5-phenylpyridin-3-yl)­benzene (TmPY), for vacuum deposition were designed and synthesized for OLEDs. TV-TmPY and TmPY with identical core structures are fully characterized to systematically investigate the impact of solution processing and vacuum deposition on the performance of phosphorescent OLEDs. Over 90% EQE (external quantum efficiency) was achieved for the solution-processed TV-TmPY-based device compared to that of the vacuum-deposited TmPY at a luminance of 1000 cd m^–2. An EQE deviation of 0.7% was observed ranging from 100 to 1000 cd m^–2 with TV-TmPY, which is the smallest value to date for solution-processed OLEDs, and over 12% EQEs were achieved for the trilayered solution-processed green and blue phosphorescent OLEDs

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017

Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. Funding: Bill & Melinda Gates Foundation

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017

Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. Funding: Bill & Melinda Gates Foundation